Quantity important in screening for alcohol abuse

Friday, April 8, 2005 | 12:00 a.m. CDT; updated 10:24 a.m. CDT, Wednesday, July 2, 2008

The potential for harmful drinking begins with two cocktails, glasses of wine or beers a day, a Missouri medical researcher says. But, unless doctors screen effectively during office visits, their patients’ alcohol abuse may go unnoticed.

To screen for hazardous drinking, doctors must ask the right question, said Dan Vinson, who believes he’s arrived at the right one following his study of people in hospital emergency rooms.

The question, “When was the last time you had more than five drinks (or four drinks for a female) in one day?” is included in Vinson’s study that was published last month in the online version of the journal Alcohol and Alcoholism.

Vinson, professor of family and community medicine at the MU, is also developing a computer tool that asks patients about their alcohol use and offers resources for cutting back. The patient and doctor can review those recommendations together.

He said time-strapped physicians don’t always ask questions that would detect a patient’s pattern of hazardous drinking. Besides, he said, many doctors mistakenly believe they can’t do much about it anyway.

Vinson, 56, said a typical 15-minute office visit leaves no time to ask a dozen questions that would gauge alcohol abuse. So he came up with one that he believes is effective.

“It has to be a question about quantity, how many drinks,” he said. “Frequency doesn’t get it.”

He said the potential for hazardous drinking could begin with two drinks a day, but the risk really begins to climb at three or four.

Vinson’s study sampled 2,517 injured people in three Boone County hospital emergency rooms from 1998 to 2000. Nationally, one-third of all injuries are alcohol-related.

He and his researchers asked each subject when they last had more than four or five drinks in a day. Follow-up interviews explored their alcohol consumption in great detail and identified alcohol dependence and abuse.

Vinson said he’s seeking funding for a study of the effectiveness of a computer tool in two dozen doctors’ offices in Missouri. Vinson said people tend to be more candid in responding to a computer than a live interviewer.

Yesterday, federal government health agencies sponsored the seventh annual National Alcohol Screening Day.

Faye Calhoun, deputy director of the National Institute on Alcohol Abuse and Alcoholism, said hundreds of colleges, supermarkets, military bases and community centers around the country are offering free and confidential alcohol screenings. Doctors shouldn’t prescribe medicine without knowing a patient’s alcohol patterns anyway, said Calhoun.

One participating center in suburban St. Louis is Florissant Valley Community College, where students, faculty and staff will be screened privately, and will review their scores with professional counselors.

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